AbbVie recently presented two posters at the 72nd American Society for Reproductive Medicine Scientific Congress & Expo (ASRM) that highlighted the many comorbidities, or related conditions, faced by women with endometriosis, as well as the economic burden of this disease in the United States.
The first presentation “Incidence of comorbidities among women with endometriosis: a retrospective matched cohort study,” reported on a large retrospective study, using commercial insurance claims data, that found statistically significant differences in gynecologic and non-gynecologic comorbidities among endometriosis patients compared to matched women without the condition.
Women with endometriosis (26,961 cases), compared to controls (107,844 cases), were seen to be almost seven times more likely to suffer from interstitial cystitis than controls, and six times more likely to have pelvic pain.
Also compared to controls, these women were some four times more likely to have a pelvic inflammatory disorder, ovarian cysts and ovarian cancer, as well as infertility and uterine fibrosis. Irritable bowel syndrome, adenomyosis (endometrial tissue growing into the uterus muscle walls) and constipation, as well as a wide range of menstrual disorders, were also more prevalent among women with endometriosis compared to controls, the researchers found.
But results showed no significant group differences in the incidence of other conditions, including eczema, endometrial cancer, peripheral vascular disease, mild liver disease, congestive heart failure, dementia, renal disease, moderate or severe liver disease, diabetes with chronic complications, AIDS, and myocardial infarction.
“We suspected that endometriosis was associated with other health risks, and it seems logical that pathological processes can result in related health deficiencies,” Dr. Eric Surrey, with the Colorado Center for Reproductive Medicine and the study’s lead investigator, told Endometriosis News. “Most notably, women with endometriosis had … a 3.9-fold higher risk for uterine fibroids and infertility, a 4.3-fold higher risk for ovarian cysts, and a 6.8-fold high risk for interstitial cystitis.”
In the second presentation, “Incremental costs of healthcare and work loss attributed to endometriosis in a cohort of commercially insured women,” AbbVie reported data from another large retrospective study showing that endometriosis is linked with substantial incremental direct and indirect costs among commercially insured patients in the U.S.
In this study, the Truven Health MarketScan Commercial claims and Health and Productivity Management Databases were used to identify women, ages 18-49 who were diagnosed with endometriosis between January 2010 and June 2014 (index date). Information on the 113,506 endometriosis patients identified was compared with that of 927,599 controls. Annual direct healthcare costs (medical and pharmacy costs), and indirect costs (absenteeism, short-term and long-term disability), were assessed for 12 months post-index in 2014 dollars.
Results found that endometriosis patients had statistically significant higher annual direct costs compared to controls ($14,648 versus $4,646, respectively) and higher indirect costs ($6,819 versus $4,687, respectively). Pharmacy costs represented 11 percent of all healthcare costs among endometriosis patients, and 26 percent among controls. The largest proportion of annual costs (62 percent) for endometriosis patients also were seen to be incurred earlier, or within three months post-index.
“As a physician, the high cost of healthcare and the out-of-pocket expense that a patient incurs is of great importance to the care and treatment they receive. We know that, based on formulary considerations, patients may not fill prescriptions or that insurance companies may not cover medications,” Surrey, a co-investigator for this study, said in the interview. “We find often that patient assistance programs aid in helping patients find their right treatment choices.”
AbbVie, in collaboration with Neurocrine Biosciences, also presented three posters and gave two oral presentations from Phase 3 studies on Elagolix, their investigational treatment for endometriosis. Another presentation highlighted the costs associated with endometriosis-related surgery.